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PubMed2000

A measure of skin familiarity and its role in the early detection of skin cancer.

Skin self-examination (SSE) is promoted widely so that individuals will become familiar with their skin and be better able to identify suspicious changes earlier. However, individuals can also become familiar with their skin other than through purposeful SSE. In this article, we develop a measure of skin familiarity based on the density of spots on 14 different areas of the body. A factor analysis of the 14 body-area scores revealed that they could be grouped into four broad body regions (shoulders and back, front of legs, back of legs, and feet). Each total body score and body-region score has high internal consistency (Cronbach's alpha coefficients ranging from 0.79 to 0.93). Moreover, the scores correlate as expected with skin self-examination behaviors and other personal characteristics, indicating high construct validity. We consider the advantages that skin familiarity measures offer over the exclusive use of SSE measures in the assessment of early detection activities and discuss the direction of future research in this area.

Factor Analysis, Statistical↗
PubMed2003

[The affect of the skin stretch on the biomechanical changes of skin].

OBJECTIVE: To investigate the biomechanical changes in skin after employing the skin stretch. METHODS: Skin samples were took from the test group which was stretched for 7 days and control group without stretch respectively in the end of 1, 2, 3, 4, 6, 8 week. The biomechanical index were measured by tensiometer. RESULTS: The mean destroy stress, breaking load, stretch rate of the test group decreased obviously in the first week (the breaking load was increasing at the beginning) and the three index increased subsequently, they reached the climax during the fourth week and turned to normal subsequently to the level of some higher than control group and normal value in the sixth week. The stiffness of the test group reached the climax at the first week and than decreased gradually to the level of some higher than normal value and control group. The biomechanical changes of te control group was not evident by comparing with the test gropu. CONCLUSIONS: Skin stretch may injured the biomechanical property during the early time and turned to normal soon afterwards. The stiffness of the skin was increased and its elasticity was decreased after performing skin stretch.

Biomechanical Phenomena↗
PubMed1992

Early and late radiation-induced skin alterations. Part I: Mechanisms of skin changes.

Early and late radiation-induced skin changes have been a concern of health professionals in radiation oncology since the early use of radiation to treat disease. Although the elicited skin reactions from solar exposure and ionizing radiation may appear to be similar, mechanisms of tissue injury are different. The time of onset, the duration, and the intensity of side effects related to radiation therapy are influenced by site of radiation field, time-dose-volume relationship, radiosensitivity of tissues in the skin, type and energy of radiation, nutritional status of the patient, adherence to skin management recommendations, and innate individual differences among patients. The effects of skin irradiation can be categorized as early and late reactions. When combined with radiation therapy, some chemotherapy agents as well as hyperthermia can enhance skin reactions.

Combined Modality Therapy↗
PubMed2007

In vitro and in vivo characteristics of frozen/thawed neonatal pig split-skin strips: a novel biologically active dressing for areas of severe, acute or chronic skin loss.

The recurrent shortage of human skin autografts or allografts used to close extensive wounds has rekindled the search for feasible alternatives. In the past, adult pig skin was a popular biological dressing, yet doubts regarding its benefits have induced most people to abandon its use. Here we investigated the aptness of neonatal pig split-skin (NPSS) strips to be used as a novel kind of temporary dressing for areas of skin loss. NPSS strips are able to be prepared in bulk amounts, stored at -80 degrees C for up to six months, and recovered by swift thawing at 45 degrees C with no change in histological structure. When set into organ cultures in vitro for up to three weeks, these frozen/thawed NPSS strips exhibited both a skin-typical energy-linked metabolism (i.e., a predominant consumption of L-glutamine instead of glucose), and an enduring ability to secrete cytokines/chemokines such as IL-1alpha, IL-6, GM-CSF, and TNF-alpha; all features alike in quantitative terms to those exhibited by freshly prepared NPSS strips directly set into culture. Moreover, once applied as temporary dressings onto deep burn wounds in vivo, frozen/thawed NPSS strips produced, for at least seven days, porcine IL-1alpha, IL-6, GM-CSF, TNF-alpha, and TGF-beta; the cytokines/chemokines importantly involved in wound healing. Hence, frozen/thawed NPSS strips not only are capable of closing extensive areas of skin loss, but even release several cytokines/chemokines beneficial to tissue regeneration and repair.

Acute Disease↗
PubMed1990

Temporal relationships between warmth imagery and associated changes in digital pulse amplitude, skin temperature and skin temperature sensation.

Temporal relationships between warmth imagery and associated psychophysiological changes were studied by recording digital pulse amplitude, skin temperature, and thermal sensations in 5 subjects. After each trial the subjects were asked whether they thought they had been successful in producing the expected mental image. During the subjectively successful imagery tasks the digital pulse amplitude and the skin temperature of the hand rose significantly. The subjective onset of imagery took place after the digital pulse amplitude had started to change but before the skin temperature had begun to rise. This implies that mental imagery of skin warming as a conscious experience is not a prerequisite of somatic change. The thermal sensation (i.e. feeling of warmth) took place while the skin temperature was rising or immediately after that. This suggests that it is not caused by the mental image per se but by activation of skin temperature receptors.

Forearm↗
PubMed1985

Effect of skin graft preparation and graft survival on the secondary contraction of full-thickness skin grafts in dogs.

The effects of 4 skin grafting techniques and graft survival on the secondary contraction of full-thickness skin grafts were evaluated. A total of 48 skin grafts were done on 12 dogs, with 2 skin grafts placed on both sides of the thorax of each dog. The grafting techniques included the sheet graft, sheet graft with continuous low-level suction provided by a butterfly catheter and evacuated glass tube, pie-crust graft, and nonexpanded mesh graft. Graft viability was assessed by visual inspection 10 days after surgical operation. Thirty skin grafts (64%) had a viability of 90% or greater. The final area of these grafts ranged from 73% to 119% of the original area. The secondary graft contraction followed a similar pattern for all graft types. During the first 10 days after surgical operation, the grafts contracted to 83% of their original area. Enlargement of the grafts began between 10 and 21 days after surgical operation. By 12 weeks, the grafts had attained a mean value of 96% of the original area. A significant difference in final area was not observed among graft types. Grafts with a high percentage of viability generally contracted less than those with larger areas of necrosis, but statistical relationship between viability and degree of contraction could not be proven. The results of the present study indicate that full-thickness skin grafts may be successfully done in dogs and that the grafts can be expected to undergo minimal postoperative contraction when graft survival is nearly complete.

Animals↗
PubMed1979

[Way of drying the skin and the renewal of skin surface activity].

The author tried to evaluate the impact of the way of drying the skin upon the renewal of its surface acidity, using a linen towel, paper towel, cellucotton and a stream of dry air. 20 persons were evaluated. Prior to the study, 1% solution of "BHP" soap had been put on their skin. PH was measured at the skin surface by a pH-meter (produced by "Radelkis") using a combined glass and calomel electrode. This method of skin drying was considered the best one, after which the average time of pH value renewal on the skin surface was the shortest, which amounted to the recovery of pH to the initial value. The way of drying the skin was found to have a significant impact on the time of pH renewal. The results were indicative of advisability of the use of linen towels.

Detergents↗
PubMed1984

Postoperative irradiation after reconstructive surgery: comparative study of radiosensitivity between free-skin grafts and skin flaps.

Radiation effects after reconstructive surgery (free-skin grafts and skin flaps) were studied in the rat, and the optimum time for irradiation was determined. The radiosensitivity of both free-skin grafts and skin flaps showed the same trend depending on time of irradiation after operation. The grafts or flaps irradiated in the hypervascular stage showed severe reactions to irradiation, whereas those irradiated in the hypovascular stage showed milder reactions in gross and microangiographic observation. Vascular damage should be given primary consideration when deciding the proper time for irradiation after reconstructive surgery. In general, free-skin grafts showed more severe reactions than skin flaps, especially in the grafts irradiated in the early stage after operation. The experimental results of this study cannot be readily transferred to a clinical setting, but they suggest that postoperative irradiation could be begun 3 to 4 weeks after operation with respect to graft or flap survival, and the results of the clinical cases almost coincide with these experimental results.

Angiography↗
PubMed1994

Pattern of skin diseases in the elderly seen at the National Skin Centre (Singapore) 1990.

A retrospective study was conducted at the National Skin Centre (Singapore) for the period 1st January 1990 to 31st December 1990 to determine the pattern of skin disorders in the elderly. A total of 2,571 patients aged 65 years and above were studied. This constituted 6.4% (2,571/39,941) of patients seen at the Centre for that year. 38.1% of the elderly patients were aged 75 years or older. The male to female ratio was 1.3 to 1. There were differences in the pattern of skin problems when compared with the young. Xerosis and asteatotic eczema were distinctly common in the elderly. The most common dermatosis in the elderly was eczema. Endogenous eczema (including seborrhoeic dermatitis, lichen simplex chronicus, hand/feet eczema, stasis eczema, generalised exfoliative dermatitis), exogenous eczema (ie contact dermatitis) and dermatitis (not otherwise specified) formed 35.3% (907/2,571) of the skin disorders encountered at the National Skin Centre. Eczema, fungal, viral infections and psoriasis were on the whole less common in the elderly compared with the general population. Common skin infestations and infections were scabies, viral warts, monilial and bacterial intertrigo and tinea corporis. Urticaria, alopecia, insect bite reactions and post-inflammatory pigmentation were uncommon referral problems in the elderly.

Aged↗
PubMed1996

Dendritic epidermal T cells in ultraviolet-irradiated skin enhance skin tumor growth by inhibiting CD4+ T-cell-mediated immunity.

Chronic UV irradiation of the skin not only causes skin cancer in humans but modifies immune responses generated within the epidermis, resulting in impaired immunity against a variety of infectious as well as noninfectious agents. In mice, tumors induced by chronic UV irradiation grow faster when transplanted into mice that are immunosuppressed by UV irradiation. To investigate epidermal cells (EC) in UV-irradiated skin that inhibit the induction of immunity against tumors, the murine UV-induced LK2 regresser tumor was used. This tumor grows initially in vivo and then spontaneously regresses. In vivo T-cell depletion was used to determine that regression of LK2 tumors in unirradiated mice was mediated mainly by CD8+ T lymphocytes, with minor involvement of CD4+ T cells. Immunization of mice with tumor antigen-pulsed EC prepared from unirradiated mice enhanced immunity against subsequent inoculation of LK2 tumors, augmenting regression of the LK2 tumor due to increased activation of both CD4+ and CD8+ T-cell subsets against the tumor. By contrast, immunization with EC prepared from UV-irradiated skin inhibited the induction of antitumor immunity, enhancing LK2 tumor growth. This was caused by the dendritic epidermal T cells that remained within this UV-irradiated EC preparation inhibiting activation of CD4+ T cells, without affecting CD8+ T cell function. Hence, during the development of murine UV-induced skin tumors, dendritic epidermal T cell inhibition of CD4+ T cell activation may enable this skin tumor to escape immune-mediated destruction.

Animals↗
PubMedDate not supplied

Skin type distribution and skin disease in Ireland.

The Irish are generally considered to have a fair complexion. We surveyed the distribution of skin type in an Irish city population (n = 1000). Skin type prevalence was as follows: type 1: 26%, type 2: 49.6%, type 3: 19.7%, type 4: 4.3%, type 5: 0.3%, type 6: 0.1%. Sunbeds were used by 16% of the population. Malignant melanoma occurred in 1.4% of patients, non-melanoma skin cancer in 6%. The high frequency of sunbed use in a fair skinned population and the high incidence of skin cancer is disturbing and highlights the need for ongoing public health education regarding ultraviolet radiation risks.

Adolescent↗
PubMed1995

Actinic damage and skin cancer in albinos in northern Tanzania: findings in 164 patients enrolled in an outreach skin care program.

Persons with albinism are particularly vulnerable to the deleterious effects of UV light on their skin. We obtained histories and performed skin examinations on 164 albino patients living in equatorial Africa to determine their sun exposure, sun protection, and sun damage. Many patients did not wear hats and most wore short-sleeved shirts. Except for four infants, all patients had sunburned skin. Actinic cheilitis, actinic keratoses, and skin cancers were detected in many patients. Sun protection methods will be important for prevention of skin damage in albino patients.

Adolescent↗
PubMed1963

Skin resistance levels and galvanic skin response: unilateral differences.

On five subjects, skin resistance levels and galvanic skin response were recorded unilaterally and simultaneously from each side of the body for between 24 and 36 days. Reliable differences in skin resistance were found in three subjects and in galvanic skin response in two subjects. The magnitude of the skin resistance difference was significantly reduced in four subjects during stimulation.

Galvanic Skin Response↗
PubMedDate not supplied

In vitro skin absorption and decontamination of sulphur mustard: comparison of human and pig-ear skin.

The aim of this study was to evaluate the use of an in vitro skin diffusion cell system as a model for assessing decontaminants against the chemical warfare agent sulphur mustard (SM). The in vitro absorption rates of SM through heat-separated human (157 +/- 66 microg cm(-2) h(-1)) and pig-ear (411 +/- 175 microg cm(-2) h(-1)) epidermal membranes were in agreement with previous in vivo studies that quoted skin absorption rates of 150 and 366 microg cm(-2) h(-1), respectively. Decontaminants (fuller's earth, Ambergard and BDH spillage granules) were ranked in order of effectiveness by measuring the skin absorption rates and the percentage of applied dose of SM that penetrated human and pig-ear epidermal membranes. The effectiveness of fuller's earth measured in this in vitro study using human epidermal membranes was in agreement with a previous in vivo human volunteer study. Similarly, the effectiveness of fuller's earth and Ambergard measured in vitro with pig-ear epidermal membranes was in agreement with a previous in vivo study conducted on rats. However, there was complete disparity in the ranking of decontaminants between human and pig-ear epidermal membranes measured in vitro. Thus, although pig-ear skin may be a relatively good model for predicting the human skin absorption of SM, it is a poor model for testing decontamination systems. The results of this study further validate the use of Franz-type glass diffusion cells containing human epidermal membranes as a model for predicting in vivo human skin absorption.

Aluminum Compounds↗
PubMed1995

Release of arachidonic and linoleic acid metabolites in skin organ cultures as characteristics of in vitro skin irritancy.

In vitro techniques make a major contribution to the development of alternatives to the in vivo "Draize" skin irritation test, and the development of sensitive and generally applicable in vitro endpoints of cutaneous toxicity is an area of intensive research. To investigate in vitro characteristics of cutaneous irritation, skin explants of rabbit and human origin were topically exposed to chemical irritants, after which the culture medium was analyzed for the presence of metabolites of both arachidonic and linoleic acid. In rabbits exposed to the potent irritant benzalkonium chloride, a direct relation was established between clinical signs of irritation and in vitro release of the proinflammatory mediator 12-hydroxyeicosatetraenoic acid (12-HETE) by the exposed skin. Histological examination revealed varying degrees of epidermal damage. 12-HETE was also the predominant hydroxy fatty acid released in a dose-dependent way by rabbit skin cultures after in vitro exposure to sodium dodecyl sulfate (SDS), benzalkonium chloride (BC), and formaldehyde (FA). Human skin cultures released, in addition to 12-HETE, predominantly 15-HETE and 13-hydroxyoctadecadienoic acid (13-HODE), omega-6 oxygenase products of arachidonic acid and linoleic acid, respectively. The irritant-induced release of hydroxy fatty acids was strongly inhibited by the lipoxygenase inhibitor eicosatetraynoic acid, indicating enzyme-mediated generation of these bioactive lipids. Comparison of hydroxy fatty acid release to more established markers of cytotoxicity (leakage of the cellular enzymes, such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), and lactate dehydrogenase (LDH)) revealed that increased levels of 13-HODE, 9-HODE, 12-HETE, and ALT were specific markers of cutaneous irritancy in rabbit skin cultures.

5,8,11,14-Eicosatetraynoic Acid↗
PubMed2000

Skin capillary appearance and skin microvascular perfusion due to topical application of analgesia cream.

Local topical analgesia changes basal skin perfusion and its regulation. In particular, the response induced by local heating, which in nontreated skin comprises a rapidly increased perfusion followed by a normalization within 30 s, is altered to a delayed and persistent perfusion increase. The response dependency to the analgesia cream application time, that is, the intradermal penetration of the analgesics and in which vascular plexa the response occurs, is not known. The aim of this study was to assess changes in the appearance of superficial skin capillaries and skin microvascular perfusion changes due to different application periods of topical analgesia cream (EMLA). Twelve subjects were treated with EMLA and placebo applied to the volar side of each forearm, respectively. The treatment areas were assigned different application times (20 min, 40 min, 1 h, 2 h, and 3 h). The areas were cleared from the creams and shortly thereafter provoked during 9 s with a probe heated to 45 degrees C. To assess capillary number density and skin perfusion, capillary microscopy, and Laser Doppler perfusion imaging (LDPI), respectively, were used. The number density of physiologically active capillary was significantly decreased with longer application times of EMLA (P < 0.005). The LDPI-signal showed a persistent perfusion increase after provocation associated with increasing application time of the cream. This perfusion pattern was not seen after 20 min of treatment, but was present in 9 of 12 subjects after 3 h of treatment. No significant relationship between changes in the capillary number density and the LDF measurement was found. In conclusion, a longer application time and therefore a higher intradermal concentration and a deeper penetration of the analgesics was associated with a delayed and persistent perfusion increase after local heating. There was a discrepancy between changes in capillary number density and skin perfusion, indicating that the perfusion increase does not occur in the capillaries but in the deeper lying vessels. Hence, the contribution of the capillary perfusion to the LDF-signal is smaller than previously anticipated. Capillary number density and presumably their perfusion were decreased with longer application times.

Administration, Topical↗
PubMed1995

Skin cancer risk and sun protection learning by helpers of patients with nonmelanoma skin cancer.

BACKGROUND: Knowledge-based skin cancer risk and prevention educational interventions by physicians and nurses were directed to subjects who had a nonmelanoma skin cancer. These high-risk patients asked relatives or friends to assist with postoperative care rendered after surgical removal of the skin cancer. The patient's experience with the nonmelanoma skin cancer was expected to raise the awareness of the helper. The study examined whether the patient became a source of information, risk assessment, and skills training for his or her helper. METHODS: Sequential patients between 30 and 60 years of age and their designated helpers completed a self-report questionnaire prior to the intervention and 1 year after the intervention. The questionnaire examined: (a) knowledge of skin cancer and sun protection; (b) individual susceptibility as determined by ease of sunburning or tanning; (c) attitudes about self-esteem, sun exposure, and health locus of control; (d) intentions to use sun protection; and (e) behaviors of sun protection used. RESULTS: Over the course of 1 year, 200 pairs were entered into the study. Both patients and helpers demonstrated an increase in knowledge after the educational intervention with the patients. There was a change in the self-reported intention to use sun protection and the behaviors of sun protection used in both patients and helpers after the intervention; however, there was no attitudinal change demonstrated in pre- and post-tests for either patients or helpers. Among both patients and helpers, gender-specific differences in attitudes, intentions, and behaviors existed. Women expressed a greater likelihood of taking precautions, including the use of sunblock; however, men reported the protective strategy of wearing a hat more than women did. Men valued a tan more than women and had greater outdoor exposure, which they restricted after the intervention. Women helpers ceased using indoor tanning devices after the intervention. Behavioral change in use of sun protection measures, including protective clothing or sunblock use and decrease in hours of outdoor sun exposure or use of indoor tanning devices, was dependent upon the patient or helper's own reported susceptibility as determined by his or her history of poor tanning and ease of sunburning. CONCLUSION: Patients transferred knowledge to their helpers. Intention to change behavior and behavioral change were strongly correlated with the individual's reported susceptibility to easy sunburning and poor tanning. Despite a lack of change in attitudes, changes in both intention to change behavior and behavior itself occurred in those who perceived themselves to be at risk. While the attitudes of participants in this study reflected popular beliefs, targeted education of high-risk adults with a nonmelanoma skin cancer caused changes in sun protection behaviors in both the patients and their helpers.

Adult↗
PubMed1981

Skin tumors induced by painting nitrosoalkylureas on mouse skin.

The carcinogenic action of nitrosamides has been investigated by applying a 0.04 M solution in acetone of 17 nitrosoalkylureas and one nitrosoalkylcarbamate to the shaved interscapular skin of female Swiss mice. Each of a group of 20 mice received 25 microliter of solution twice a week for 40 or 50 weeks, after which the animals were observed until death or 100 weeks. The appearance and progression of skin tumors within the painted area was charted for each animal. Nitroso-2-fluoroethylurea was toxic to the skin and was retested using a 0.01 M solution in acetone. No tumors was seen with nitrosoallylurea, nitroso-iso-butylurea, nitrosobenzylurea, and nitroso-2-phenylethylurea. The most potent compounds were nitrosomethylurea, nitrosoethylurea, and nitroso-2-fluoroethylurea. Nitroso-n-amylurea and nitroso-n-hexylurea were somewhat less potent, each inducing tumors in 11 of 20 mice. Nitrosocarbaryl gave rise to skin tumors in eight mice. The remaining compounds, nitroso-n-propylurea, nitroso-iso-propylurea, nitroso-n-butylurea, nictroso-sec-butylurea, nitroso-n-undecylurea, nitroso-n-tridecylurea, nitrosophenylurea, and nitrosocyclohexylurea were much less effective skin carcinogens, yielding tumors in from one to five mice. No good correlation was apparent between the relative stability of the compounds, their mutagenicity to Salmonella and their carcinogenicity to mouse skin.

Animals↗